{%extends "_base.html"%}

{% load mercyDMS_extras %}

{%block content%}
<ol class="forms">
<center><li>Starred items (*) are required</li></center>
<form name="newForm" method="post">
{{newForm.as_ul}}
<input type="submit" class="FormButton" name="save" value="Apply Now">
</form>
</ol>
{%endblock content%}
